Dr. Robin’s Covid-19 Updates

Covid Mutations: The Good, The Bad, The Ugly

Be Not Terrified. But Keep Your Eye on The Spike.

Lots of people I know are worried about the new “variants” of SARS-CoV-2 (the virus that causes COVID-19 illness) now being observed in England and South Africa. Some headlines call them the “mutated Covid” (an ugly, scary word) or “a new kind of Covid” that may be more transmissible.

People are wondering what a “mutated Covid” could mean to us, how it might affect travel or schools, and the possible impact on vaccination effectiveness. Many people (and headlines) have started to theorize about Worst Possible Scenarios. But if you look beyond the headlines, the reality is we don’t yet know if this is a dangerous situation.

Viruses mutate all the time, with no impact whatsoever; it’s a normal turn of events. Scientists looking for new mutations via genomic sequencing have already found tens of thousands of different Covid mutations (Wuhan’s virus is different than Italy’s). They will find more mutations, every day, every week.

In England, where scientists do a lot of genomic sequencing, they have found increasing numbers of a “variant” of SARS-CoV-2 with about 20 specific mutations. Many of these mutations have been seen before with no adverse consequences. A few are involved with the spike protein.

Since they’re seeing more of this specific “dominant” variant, it makes them wonder if this means it has become more transmissible, e.g., it can more easily get into our cells. The mathematical models in their report implied, yes, this variant might well be easier to catch.

Politicians, previously slow to react, responded to this news by immediately issuing strong travel and social distancing rules. However, it’s important to realize these recommendations are based on mathematic models — not real life — and also without data on lethality, immunity, vaccine effectiveness, etc.

These new rules were not based on hospitalizations or deaths, or lab tests where they isolate the actual live virus, just conjecture. These are educated guesses based on elegant models but with incomplete and evolving data.

It is another “abundance of caution” moment in a pandemic that has had many examples of guidance given before all the data is available.

It is a fact that this particular combination of mutations is now going to be seen in higher numbers wherever we look. (So far we haven’t looked very much— ie. done genomic sequencing — but that is going to change in a hurry). This may mean the virus is more transmissible, or it might be a coincidence. It might represent a concerning turn of events — or it may not.

All throughout history, viruses typically mutate to become more transmissible and less lethal. (This makes sense from an evolutionary standpoint: viruses want to spread and survive in more hosts — and they can’t do that if they kill all their hosts off.) We have seen this happen in virology history over and over again. Perhaps that’s what’s happening here. We just don’t know yet.

There is so much we don’t know.

Big questions:

Q). What does it mean for our lives right now?

A). Nothing different right now. We need to do all the usual “risk mitigation strategies” — distance, mask, wash — while we wait for the science to help us learn all we don’t yet know.

Q). What kind of science do we need to learn next?

A). A lot:

1) The very basic question: Are we seeing it more of this variant because it’s mutated in a way to be more transmissible, or is it because of some super spreader people or lax distancing or something else?

2) Are our traditional tests picking it up at the correct rates?

3) Does this variant affect viral load, and does that affect the course of the illness?

4) Does this variant lead to more serious illness?

5) Does this variant lead to more deaths?

6) Etc., etc., etc.

Q). So if this variant turns out to be a bad actor (more transmissible and/or more lethal) and sticks around for a while, could it be “resistant” to the vaccine, ie end up with the vaccines less effective?

A). This currently appears to be improbable in the short-term but is being studied. And, if it were to happen, the mRNA scientists say it’s easy for them to adjust their vaccines to better match any new variant.

It is, however, likely in the long-term. At some point — probably not today but someday — the virus may well mutate to become resistant to the two vaccines we have today. That’s why we need multiple vaccines and approaches. And that’s why there’s currently almost 30 other vaccine projects going on.

— — — — — — — — — — — — — — — — — — — — — — — —

Science will continue to respond to our need to “build the plane while we fly it.” They’ll get us the data we need about this new variant, they’ll get us the data we will need about future variants, and they’ll help us if we need to create even more crafty vaccines in the future.

In the meantime, guess what’s the best way to keep a virus from mutating? Don’t let it replicate!

How do you keep it from replicating? Don’t let it get inside you! Don’t let it get anywhere near you, don’t give it a chance to invade your lung cells!

How do you do that? By all the usual risk mitigation strategies you already know by heart (distancing, masking, vaccinating).

For all the scary headlines about “Mutant Virus!” it’s kind of amazing to realize we can actually be our own veritable “Mutant Masters” simply by wearing a mask.

{Robin Schoenthaler, MD is a Boston-based cancer doctor who has been writing straightforward fact-based no-blame-no-rumors-all-science-all-the-time essays about Covid-19 every week since March 2020.}

Covid-Translator. Cancer doc: ~Three decades at MGH. Writer and storyteller: Moth Grand Slam Champion. Mom. www.DrRobin.org, @robinshome, robinshome2@gmail.com

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